A young friend of mine, C. is in hospital and I am extremely anxious about her. Her weight has dropped to a dangerous level. She (and I don't often see her and get this information from a mutual friend, S.) denies that she is anorexic, however, as she knows she is too thin and says she wants to eat, but she gets stomach cramps after eating most foods and so is afraid to eat - she associates anorexia with a mistaken body image. She has been tested for many allergies and illnesses, with negative results.
It seems to me that accepting her assertion that she is not anorexic is not helping her at all. It seems self-evident to me that she is suffering from an eating disorder, however you categorise it. She was in hospital a few months ago, but only because she collapsed; until then she had never been to the doctor at all about this problem. S. is much more comfortable with calling it a food allergy than anorexia, but I don't see why. It is an illness, there is no shame in it. If I had a nervous breakdown or suffered from bi-polar disorder, I should not be shunned because my illness was more of the mind than the body.
C's mother has tried to take the pragmatic route, which would be the way my mind works too - look, you may feel pain after food, but it is still nourishing you, just eat little and often and it will be doing you some good. But she can't, won't - and weighs about 4 stone. Which is 56 pounds. 25 kilos. If it drops more, she will die.
She is on a drip in hospital now, as she is so low in various vitamins, and on a fairly strict regime, told she has to eat 1500 calories a day and then build up from that. But until she understands the problem, she is not capable of breaking away from it.
My mother developed anxieties about foods and all I could do was try to accommodate her wishes as much as I could, while making sure she took in as much nutrition as possible. But she was in her seventies, and physically ill too.
C. is only thirty, strong willed, intelligent and independent. Can you help someone who denies that she needs help?
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17 comments:
aaaah. z. i am so sorry for c. and for you, and for c's mum.
anorexia is one of the hardest diseases, because the mind is so powerful in it's ability to control.
i could wax on about treatment/causality/recovery, but you being a smart woman knows all of this already, so instead, just know i am thinking of you all, and that yes, it is an extraordinarily horrifying experience, and one that is so hard to understand.
Jen, thank you. If anyone will have a deep compassion and sympathy for C and all around her, it is you.
I am shocked at her weight - how can she possibly DO anything? She must be pure skeleton and skin. How very sad.
I hope hope hope she comes right and gets help sorting her mind. You're spot on - there is no shame in a mental illness...but many people see it as a terrible weakness.
You know - tomorrow I have an informal hearing at work, with HR, because of my 10 day absence from work (ordered by my GP) - very much needed to recover from a near breakdown. But my employer feels it was unnecessary and put him at great inconvenience (not really actually - I was well covered by other staff)..however it is not tolerated at work to be emotionally weak at any time. The show must go on!
I am to receive a written for that, as well as for contacting clients directly.
I feel for C - she must be under a lot of internal pressure and in huge turmoil to be so blind to her problem. Perhaps in denial too.
My sister has bipolar and so did my Dad - my grandfather had a nervous breakdown after the war and never recovered..he was like a chile all my life....yet I don't see any of them as inferior people. They have amazing strengths.
Oh this is so sad.
Wendz darling, I'll be thinking of you tomorrow. I hope it's not too much of an ordeal.
And thanks.
Isn't there a specialist eating disorder unit in her area?
IME, without such specialist help women with eating disorders never recover and it becomes a never-ending cycle of hospital admission, gain weight, discharge, lose weight, hospital admission etc. It is quite wrong for a normal hospital to even attempt to deal with such a severe case as your friend's.
Could you do some research and make some suggestions to the consultant in charge of her care?
Good luck.
I completely agree with what you say, BW.
I don't know what sort of specialist care is available where she lives, or whether she would accept it - as she has decided she has multiple food intolerances she may only agree to go to specialists dealing in strictly physical problems. At present, the hospital is concerned with stabilising her condition, which is on a knife-edge.
I've known her for a long time, since she was at school, but only see her occasionally as she now lives quite a long way away. She visits her parents (whom I don't know) every few weeks and then I usually see her at church. We are very fond of each other but I can't say I know her well. But S, who does, says that she has tried to talk to her and C completely blocks her - she agrees with everything said and says she tries to eat but most food makes her ill.
Of course, it is possible that she has a condition that has triggered this off; I'm not saying that it is an eating disorder and nothing else. But, as I said to S when she said it's not anorexia, if you or I were not able to eat and lost weight drastically, we'd go to the doctor at once, not wait until collapsing at work.
And thanks
It's confusing really, because anorexia is these days so much associated with deliberate starvation and body-image, when it is or can be so much more than that. Also, it is such a personal thing, food.
I went down to 5 1/2 stone, and I didn't think I was anorexic because I was not trying to lose weight and I knew I was too thin, I was just too upset to eat. It made me nauseous. For about a year. Quite literally it was a nervous loss of appetite.
I stopped looking at my weight when it got to 5 1/2 (I had been around 8 or 9), because that would have meant I'd have to do something about it, and I was just hoping the problem would go away. Eventually, it did, but I kept myself going by forcing myself to drink a glass of milk and a glass of orange juice every day. It was an effort, I have to say, but it got me through. And now I'm good and buxom. And happy, to boot.
I think you have to be very patient and cunning to help someone who denies that they need help. You have my very best wishes in this.
C
Most of the websites I look at assume that a too-thin person has a mistaken body image. Food phobias are assumed to relate to children. She must be unhappy and we are concerned that too much pressure from friends will make her worse. Like you, she has to decide to recover and I hope she does that.
And well done to you. And thank you.
Food phobias. Now that's another thing altogether. I've had that since the year dot. I'm 33 and have never eaten a piece of fruit or a vegetable, and some other random things too. I don't equate that to any current unhappiness or distress though, it's just a hangover from stuff that bothered me as a child. Ironically, that was probably the same stuff that led me indirectly into the situation that made me too upset to eat anything. But I try to be emotionally literate, and I wonder if your friend is willing to recognise any emotional component in her situation.
There is nothing worse than people putting pressure on you to eat stuff to make them happy, or not have to worry about you, when in fact eating is the least of your worries, and maybe that's the only way you have to express your distress. Maybe she'd be prepared to drink stuff like I did, even if she doesn't feel up to eating, though I think the key is she has to be doing it for herself, and not in order to please someone else.
Isn't 'cheer up' a deeply annoying expression?
I do agree that she needs to understand herself to have a chance to recover.
Yes. Especially when men say it to you when they don't even know you, and you didn't even need to cheer up, you were just thinking too many important things to be paying any attention to them.
It's very easy and comforting to think that other people's phenomemology is similar to one's own - I like to think everyone must understand themselves to some extent, even if only secretly. Then again, in the words of an eminent psychiatrtist "it's amazing how emotion can stop you from thinking".
As for your friend C, someone's got to just happen to say the right thing to her, to either get her thinking, or to get her acting on her thinking. I feel like giving her a ring myself :-)
Actually, there are plenty of things worse than people putting pressure on you to eat stuff to make them happy. I did not mean to disregard people who've suffered much worse things. That comment was strictly context-dependent.
Talking to a nurse practitioner mental nurse I knew today, I asked her for an opinion on this one. She said that, in such a severe case, sectioning the person to an appropriate treatment centre may be the only way to save her life. She said that she has been involved in several cases where this had been done.
I asked whether there was any research showing the effectiveness of such measures and she had no idea. That worried me.
I then asked whether people who were morbidly obese and in serious danger of death were also sectioned. She said not to her knowledge.
What an interesting world we live in.
Thanks for your really helpful and constructive comments. As I said, right now the focus is on helping her through this immediately critical stage. After that, I'll let you know what happens, and if you can help at all.
Really, thanks. xx
Yes, BW. Smokers, drug addicts and alcoholics should be sectioned too. That would be so cool.
I agree with you Clarice.
And all the best to your friend, z.
Thanks, sweetie.
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